Avoiding Medicare Fraud and Abuse

Avoiding Medicare Fraud and Abuse

Medicare is a government-funded program that tries to ensure quality care is accessible for its beneficiaries. The program also focuses on its own wellbeing by ensuring that they are not being taken advantage of. The government established a Medicare Fraud Strike Force, which is a multi-agency team of state, local, and federal investigators who work to combat fraud.

Medicare fraud occurs when doctors or other medical professionals knowingly bill the Medicare system for supplies, services, and other care that they did not provide. There are many forms of Medicare fraud in the United States. Knowing what is considered fraud can help you be proactive to ensure you do not face allegations in the future.

Medicare Billing Fraud

Many innocent billing errors occur every day across the United States. Merely entering the wrong billing code can result in billing for ineligible services. Most errors are entered mistakenly and not intended to be fraudulent. There are various ways that billing errors can resemble fraud, including:

  • Causing providers to receive payment for services they never rendered
  • Causing the overbilling of products and services
  • Billing for unbillable services
  • Billing for unnecessary services

If you were accused of committing Medicare fraud due to a billing error, it is crucial that you reach out to a healthcare fraud defense attorney as soon as possible.

Actions Considered as Medicare Fraud

Medicare fraud is more severe than billing errors. Engaging in billing fraud is illegal, which means a conviction often results in far more severe consequences for those who commit these crimes. If someone at your facility is committing Medicare fraud, you can be held liable for their actions. It is crucial that you remain aware of what is going on so you can detect these actions and address them immediately. It is essential to be mindful of doctors, nurses, and other providers who:

  • Bill patients for several tests without actually performing them
  • Use telemarketing scheme to offer products and services to patients
  • Routinely waive copays for patients
  • Regularly charging copays to patients even though the insurance waives them
  • Claims that Medicare endorses their products or services
  • Claims they know how to get Medicare to pay for services that are not covered under a patient’s plan

It is crucial to continually review what goes on in your clinic or facility to ensure others are not engaging in illegal actions. Not addressing Medicare fraud or billing fraud as soon as possible can result in extensive fees, fines, and closures for providers.

Healthcare Fraud Group Can Help You

If you have been accused of healthcare fraud, it is crucial that you take immediate action to ensure your legal rights are protected. Our team of aggressive attorneys at Healthcare Fraud Group works diligently to ensure those accused have the best legal defense imaginable so they can get back to their lives and move forward. Contact our national federal criminal defense law firm today at (888) 402-4054 to get help with your case.

Schedule a Confidential Initial Compliance Assessment with Our Federal Health Care Group